Antineoplastics - concepts Flashcards
What is cancer?
A disease of altered cell growth, cell division, and cell differentiation.
A mass of tissue, the proliferation of which is not controlled by normal physiological processes
What happens to growth factors in cancer cells?
Increased - there is increased intracellular signals to cells to divide
What happens to cyclin-dependent kinases in cancer cells?
Increased - they also tell cells to divide
What happens to gene expression in cancer cells?
It’s altered in some way
p53 gene is DECREASED - this allows mistakes in DNA replication to not be caught (normally this would cause apoptosis) and the cell continues to divide even with the mistakes in DNA
What happens to contact inhibition in cancer cells?
Decreased
Cells normally stop dividing once they come in contact with other cells, but not in cancer - they keep dividing
What’s the most common type of cancer in men?
Prostate
What’s the most common type of cancer in women?
Breast
What’s the most common type of cancer in children ages 0-14?
Acute lymphocytic leukemia then brain/CNS
What’s the most common type of cancer in adolescents ages 15-19?
Hodgkin lymphoma then thyroid carcinoma, then brain/CNS
What is the deadliest cancer in men?
Lung, then prostate
What’s the deadliest cancer in women?
Lung, then breast
What is hyperplasia?
Increase in size or number of cells
Function is unchanged
It is reversible
What is metaplasia?
Adaptive substitution of one differentiated cell type for another differentiated cell type (ie callouses with chronic irritation)
Protective response
Some loss of function
What is dysplasia?
Loss of uniformity
Loss of architectural orientation
Still reersible
What is neoplasia?
Uncoordinated growth
Decreased response to suppressor genes (p53, cyclin-dependent kinases)
Immortalization
Irreversible
Describe benign tumor cells
Localized
Enclosed in a fibrous capsule
Surgically removable
Patient usually survives
Describe malignant tumor cells
Spreads to and destroys adjacent tissue
No capsule
Can metastasize
Can result in death of patient
Describe grade 1 tumors
Closely resembles tissue of origin; retains specialized function
Describe grade 2 tumors
Moderately differentiated, less like tissue of origin, increased mitotis
Describe grade 3 tumors
Poorly differentiated, tumor doesn’t resemble tissue of origin, increased variation, increased mitosis
Describe grade 4 tumors
Very poorly differentiated, no resemblance to tissue of origin, highly variable, enhanced mitosis, metastatic
True or false: Single “clone-ogenic” tumor stem cell has potential for unlimited replication
TRUE
So you must kill EVERY tumor stem cell
True or false: Different tumors have the same growth patterns, which are the same during the same stage of disease
False
Different tumors have different growth patterns which can change based on stage of disease
Which type of cancer is well differentiated? Which is non-differentiated?
Early lung cancers
Lung cancers
What type of cancer is slow? What type of cancer is fast?
Colon, prostate are slow
Leukemia is fast
What is gompertzian growth?
99.9% of tumor cells are killed each round of chemo, you lose 3 log units every time
In between the rounds of chemo the tumor continues growing but you just kill it off again
Treatment should involve what as the first step?
Removal of the tumor
Surgery
Radiation
Chemotherapy
When can tumors be surgically removed?
Well-localized and well-differentiated
When can tumors be removed by radiation?
Localized tumors that aren’t easily removed
When can tumors be removed by chemotherapy?
Targets all rapidly dividing cells
Systemic effects increases chances against metastatic cells
At what amount of cells do you usually see diagnosis?
10^9
At what amount of cells do you usually see symptoms?
10^10.5
At what amount of cells do you usually see death?
Over 10^12
What drug classes are cell cycle non-specific?
Alkylatic drugs
Intercalating drugs
What drugs act in the S phase?
DNA synthesis inhibitors
What drugs act in the transition from S to G2 phase?
Bleomycin
Etoposide
What drugs act at the M phase?
Mitotic inhibitors
What drugs act in the G1 phase?
None specifically act at the G1 phase
Benefits of combination therapy?
Minimizes resistance
Minimizes toxic effects
What types of adjuvant therapies are used?
Antiemetic drugs
Stimulate bone marrow growth
Why do you see alopecia with cancer treatments?
BC drugs target rapidly growing cells and kill them, hair cells are constantly growing so to kill them means to lose hair
What side effects are seen in all cancer treatments that target rapidly dividing cells?
Bone marrow suppression (myelo and immune suppression)
GI tract ulcers (mouth sores)
Alopecia (hair loss)
Decreased sperm count and menstrual irregularities
